| 1. |
- Ahlin, Catharina, et al.
(författare)
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Implementation of a written protocol for management of central venous access devices : a theoretical and practical education, including bedside examinations.
- 2006
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Ingår i: Journal of Infusion Nursing. - : Lippincott Williams & Wilkins. - 1533-1458 .- 1539-0667. ; 29:5, s. 253/294 quiz-259/296
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to evaluate registered nurses' (RN) compliance with a local clinical central venous access device (CVAD) protocol after completing an educational program and to determine RNs' perception of the program. Seventy-five RNs working in hematology participated in the educational part of the program. Sixty-eight RNs were examined while changing CVAD dressings or placing a Huber needle into a port on actual patients. Sixty percent of the RNs passed the examination and reported that the program increased their knowledge. The results indicated that the educational program could be recommended for use when implementing a new clinical protocol.
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| 2. |
- Böthun, Alicia, et al.
(författare)
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Jaw–neck motor strategy during jaw‐opening with resistance load
- 2022
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 49:5, s. 514-521
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Tidskriftsartikel (refereegranskat)abstract
- Background: The jaw and neck motor systems have a close functional integration but the effect of resistance load to the mandible during jaw opening on the jaw-neck integration is not known.Objectives: To evaluate the effect of resistance load compared to no load on integrated jaw and neck motor function in individuals free from pain and dysfunction in the jaw and neck regions.Methods: Jaw and head movements during continuous jaw opening were recorded with an optoelectronic system (MacReflex® ) in 26 pain-free individuals (14 women, 12 men, mean age 22 years). Jaw opening was performed with and without resistance load (1600 g) to the mandible. The relationship between jaw movement amplitude, head movement amplitude, head/jaw ratio (quotient of head and jaw movement amplitude) and resistance load were modelled using linear mixed-model analysis. A p-value <.05 was considered statistically significant.Results: The expected head/jaw ratio mean was increased by 0.05 (95% CI: 0.03, 0.08, p < .001) with resistance load as compared to no load. This corresponds to an increase in expected mean by 55.6%. With resistance load, expected mean head movement amplitude increased by 1.4 mm (95% CI: 0.2, 2.5, p = .018), and expected mean jaw movement amplitude decreased by 3.7 mm (95% CI: -7.0, -0.5, p = .025).Conclusion: There is a compensation and adaptation of integrated jaw-neck motor function with an altered jaw-neck motor strategy during jaw opening with resistance load compared to no load. The head/jaw ratio demonstrates increased proportional involvement of the neck during increased load on the jaw system.
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| 3. |
- Wiesinger, Birgitta, et al.
(författare)
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Does induced masseter muscle pain affect integrated jaw-neck movements similarly in men and women?
- 2016
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 124:6, s. 546-553
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Tidskriftsartikel (refereegranskat)abstract
- Normal jaw opening-closing involves simultaneous jaw and head-neck movements. We previously showed that, in men, integrated jaw-neck movements during jaw function are altered by induced masseter muscle pain. The aim of this study was to investigate possible sex-related differences in integrated jaw-neck movements following experimental masseter muscle pain. We evaluated head-neck and jaw movements in 22 healthy women and 16 healthy men in a jaw opening-closing task. The participants performed one control trial and one trial with masseter muscle pain induced by injection of hypertonic saline. Jaw and head movements were registered using a three-dimensional optoelectronic recording system. There were no significant sex-related differences in jaw and head movement amplitudes. Head movement amplitudes were significantly greater in the pain trials for both men and women. The proportional involvement of the neck motor system during jaw movements increased in pain trials for 13 of 16 men and for 18 of 22 women. Thus, acute pain may alter integrated jaw-neck movements, although, given the similarities between men and women, this interaction between acute pain and motor behaviour does not explain sex differences in musculoskeletal pain in the jaw and neck regions.
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| 4. |
- Wiesinger, Birgitta, et al.
(författare)
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Experimental masseter muscle pain alters jaw-neck motor strategy
- 2013
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 17:7, s. 995-1004
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Tidskriftsartikel (refereegranskat)abstract
- Background: A functional integration between the jaw and neck regions has been demonstrated during normal jaw function. The effect of masseter muscle pain on this integrated motor behaviour in man is unknown. The aim of this study was to investigate the effect of induced masseter muscle pain on jaw-neck movements during a continuous jaw opening-closing task.Methods: Sixteen healthy men performed continuous jaw opening-closing movements to a target position, defined as 75% of the maximum jaw opening. Each subject performed two trials without pain (controls) and two trials with masseter muscle pain, induced with hypertonic saline as a single injection. Simultaneous movements of the mandible and the head were registered with a wireless optoelectronic three-dimensional recording system. Differences in movement amplitudes between trials were analysed with Friedman's test and corrected Wilcoxon matched pairs test.Results: The head movement amplitudes were significantly larger during masseter muscle pain trials compared with control. Jaw movement amplitudes did not differ significantly between any of the trials after corrected Wilcoxon tests. The ratio between head and jaw movement amplitudes was significantly larger during the first pain trial compared with control.Conclusions: Experimental masseter muscle pain in humans affected integrated jaw-neck movements by increasing the neck component during continuous jaw opening-closing tasks. The findings indicate that pain can alter the strategy for jaw-neck motor control, which further underlines the functional integration between the jaw and neck regions. This altered strategy may have consequences for development of musculoskeletal pain in the jaw and neck regions.
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| 5. |
- Wiesinger, Birgitta, et al.
(författare)
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Jaw-opening accuracy is not affected by masseter muscle vibration in healthy men
- 2014
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Ingår i: Experimental Brain Research. - : Springer Science and Business Media LLC. - 0014-4819 .- 1432-1106. ; 232:11, s. 3501-3508
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Tidskriftsartikel (refereegranskat)abstract
- There is a functional integration between the jaw and neck regions with head extension–flexion movements during jaw-opening/closing tasks. We recently reported that trigeminal nociceptive input by injection of hypertonic saline into the masseter muscle altered this integrated jaw–neck function during jaw-opening/closing tasks. Thus, in jaw-opening to a predefined position, the head–neck component increased during pain. Previous studies have indicated that muscle spindle stimulation by vibration of the masseter muscle may influence jaw movement amplitudes, but the possible effect on the integrated jaw–neck function is unknown. The aim of this study was to investigate the effect of masseter muscle vibration on jaw–head movements during a continuous jaw-opening/closing task to a target position. Sixteen healthy men performed two trials without vibration (Control) and two trials with bilateral masseter muscle vibration (Vibration). Movements of the mandible and the head were registered with a wireless three-dimensional optoelectronic recording system. Differences in jaw-opening and head movement amplitudes between Control and Vibration, as well as achievement of the predefined jaw-opening target position, were analysed with Wilcoxon’s matched pairs test. No significant group effects from vibration were found for jaw or head movement amplitudes, or in the achievement of the target jaw-opening position. A covariation between the jaw and head movement amplitudes was observed. The results imply a high stability for the jaw motor system in a target jaw-opening task and that this task was achieved with the head–neck and jaw working as an integrated system.
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| 6. |
- Wiesinger, Birgitta, 1963-, et al.
(författare)
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Multimodal Sensory Stimulation of the Masseter Muscle Reduced Precision but Not Accuracy of Jaw-Opening Movements
- 2019
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Ingår i: Frontiers in Neuroscience. - : Frontiers Media S.A.. - 1662-4548 .- 1662-453X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- A functional integration between the trigeminal and craniocervical sensorimotor systems has been demonstrated, with simultaneous jaw and head–neck movements during jaw opening–closing. We previously showed that pain induction in the masseter muscle increased the relative contribution of the neck component of integrated jaw–neck movements. Induced pain or manipulation of proprioception by vibration did not affect accuracy during a jaw-opening task in men. It is not known how multimodal sensory stimulation, with a combination of pain induction and vibration, affects jaw-opening accuracy and precision. The aim was to investigate how jaw–neck movements, and specifically accuracy and precision of jaw-opening, are affected during concomitant nociceptive and proprioceptive stimulation of the masseter muscle. Twenty-one healthy men performed jaw-opening to a target position, defined as 75% of individual maximum jaw opening, during control (Ctr), vibration of masseter muscles (Vib), pain induction in the masseter (Pain), and concomitant vibration and pain induction in the masseter muscle (VibPain). Simultaneous jaw and head movements were recorded with an optoelectronic system and amplitudes calculated for each jaw opening–closing cycle. Accuracy of jaw movements was defined as the achievement of the target position. Precision of jaw movements was defined as the cycle-to-cycle variability from the mean of cycles 2–10 (coefficient of variation, CV). Differences between the trials were analyzed with Friedman’s test, Dunn’s test, and Benjamini–Hochberg correction. There were no significant differences between the trials for jaw movement amplitudes. For head movements, amplitudes for cycles 2–10 were larger during Pain compared to Ctr and Vib (both p = 0.034), and larger during VibPain compared to Ctr (p = 0.034) and Vib (p = 0.035). There were no differences in accuracy of jaw movements between the trials. For precision of jaw movements, the cycle-to-cycle variability was larger during VibPain compared to Ctr (p = 0.027) and Vib (p = 0.018). For integrated jaw–neck motor strategy, there was a difference between pain and non-pain trials, but no differences between unimodal and multimodal stimulation trials. For achievement of jaw-opening to a target position, the results show no effect on accuracy, but a reduced precision of jaw movements during combined proprioceptive and nociceptive multimodal stimulation.
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| 7. |
- Berggren, Elisabeth, et al.
(författare)
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Identity construction and meaning-making after subarachnoid haemorrhage
- 2010
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Ingår i: British Journal of Neuroscience Nursing. - : MA Healthcare Ltd.. - 1747-0307 .- 2052-2800. ; 6:2, s. 86-93
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim was to analyse people's accounts of subarachnoid haemorrhage (SAH) and to describe how they initiate and create meaning for the onset and events surrounding the SAH.Background: Being struck by a SAH is a dramatic event, often followed by unconsciousness. There is therefore a special need for a patient to try to create some kind of meaning for the event during recovery and afterwards.Method: Nine interviews were carried out in home settings and discourse analysis was used to interpret the data.Findings: People stricken by SAH seem to be able to judge from memory for when they were becoming ill. Critical events related to SAH were existential threats and existential insights; and time as 'waiting' and time as 'structuring meaning'. The reconstruction of the illness event may be interpreted as an identity-creating process.Conclusion: The reconstruction of the illness is a tool that can be used by nurses and other health professionals to understand a patient's self-positioning and identity-construction.
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| 8. |
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| 9. |
- Böthun, Alicia, et al.
(författare)
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Clinical signs in the jaw and neck region following whiplash trauma : A 2-year follow-up
- 2023
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Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 27:6, s. 699-709
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain in the orofacial region is often reported after whiplash trauma. However, prospective studies evaluating clinical signs related to orofacial pain and disability in whiplash populations are rare. The aim of the present study was to evaluate clinical signs related to pain and dysfunction in orofacial and neck regions after whiplash trauma, in a short- and long-term perspective.Methods: In total, 84 cases (48 women) diagnosed with neck distortion after a car accident and 116 controls (68 women) were examined within 1 month, and 49 cases (27 women) and 71 controls (41 women) were re-examined 2 years later. Outcome measures were pain on palpation of jaw and neck muscles and maximal jaw opening. Analysis was performed using mixed-models.Results: Cases and women were at higher risk for pain on palpation of jaw muscles (OR:7.7; p < 0.001 and OR:3.2; p = 0.010 respectively) and neck muscles (OR:12.7; p < 0.001 and OR:2.9; p = 0.020 respectively) but with no significant effect of time. Cases and women also had lower maximal jaw opening (−3.1; p = 0.001 and −3.3; p = 0.001 respectively). There was no significant time effect, but a significant interaction between cases and time (2.2; p = 0.004).Conclusion: Individuals with a whiplash trauma present a higher risk for pain on palpation in jaw and neck muscles both in a short- and long-term perspective, but show normal jaw movements. No time effect suggests that cases do not spontaneously improve nor get worse. Investigating pain on palpation in the jaw and neck muscles after whiplash trauma can identify individuals at risk for developing long-term orofacial pain and dysfunction.Significance: Orofacial pain is often reported after whiplash trauma but most previous studies concerning orofacial pain in whiplash populations have been questionnaire studies. Cases with a previous whiplash trauma and women, in general, had higher risk for pain on palpation in the jaw and neck region. Investigating pain on palpation after a whiplash trauma can help to identify individuals at risk of developing long-lasting pain in the orofacial region.
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| 10. |
- Böthun, Alicia, et al.
(författare)
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Whiplash trauma did not predict jaw pain after 2 years : an explorative study
- 2024
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Ingår i: Clinical Oral Investigations. - : Springer Nature. - 1432-6981 .- 1436-3771. ; 28
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore predictive factors for the development and maintenance of jaw pain over a 2-year period.Methods: One hundred nineteen cases (73 women) and 104 controls (59 women), mean age 34.9 years (SD 13.9), attended baseline and 2-year follow-up examinations. The whiplash cases visited the emergency department at Umeå University Hospital, Sweden, with neck pain within 72 h following a car accident, and baseline questionnaires were answered within a month after trauma. Controls were recruited via advertising. Inclusion criteria were age 18–70 years, living in Umeå municipality and Swedish speaking. The exclusion criterion was neck fracture for cases and a previous neck trauma for controls. Validated questionnaires recommended in the standardized Research Diagnostic Criteria for temporomandibular disorders were used. Jaw pain was assessed by two validated screening questions answered with “yes” or “no.” A logistic regression analysis was used to predict the outcome variable jaw pain (yes/no) after 2 years.Results: Whiplash trauma did not increase the odds of development of jaw pain over a 2-year period (OR 1.97, 95% CI 0.53–7.38). However, non-specific physical symptoms (OR 8.56, 95% CI 1.08–67.67) and female gender (OR 4.89, 95% CI 1.09–22.02) did increase the odds for jaw pain after 2 years.Conclusion: The development and maintenance of jaw pain after whiplash trauma are primarily not related to the trauma itself, but more associated with physical symptoms.Clinical relevance: The development of jaw pain in connection with a whiplash trauma needs to be seen in a biopsychosocial perspective, and early assessment is recommended.
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